Appropriateness of Medications in Prescriptions of Elderly Patients in a Selected Area and in a Selected Government Hospital

Abstract

Elderly are more vulnerable to inappropriate prescriptions. The objective of this study was to assess the appropriateness of medicines in prescriptions among elderly patients in the community and hospital setting. The study was conducted in a selected Grama Niladhari division and in a selected hospital in Colombo district. All aged ≥ 60 years who were on long term medicine were interviewed by two pharmacists. Regular medicines used by them were recorded from health records. Potentially Inappropriate Medicines (PIMs) and Potential Prescription Omissions (PPOs) were detected using the 'Screening tool of older person's prescriptions' (STOPP) and 'Screening tool to alert doctors to right treatment' (START)criteria. A total of 468 prescriptions were analyzed and at least one PIM was identified in 338 prescriptions. Among the prescriptions analyzed, the mean number of drugs prescribed was 5.86 and the total number of STOPP PIMs was 171 (36.54%) and the number of START- PPOs was 296 (63.23%). Hypertension and diabetes mellitus were identified as most common diseases in both settings. A significant positive relationship was seen between the total number of prescription drugs and the number of PIMs detected (P<0.001). A significant number of PIMs were identified in the prescriptions of elderly. Incompleteness and unavailability of health records limited the application of the STOPP/START as an effective tool to detect PIMs in both hospital and community settings.